Transfusão de sangue em terapia intensiva: um estudo epidemiológico observacional

Abstract

JUSTIFICATIVA E OBJETIVOS: A transfusão de concentrado de hemácias (CHA) é muito freqüente no centro de tratamento intensivo (CTI), mas as conseqüências da anemia nos pacientes gravemente enfermos ainda são obscuras. Os objetivos desse estudo foram avaliar a freqüência, as indicações, os limiares transfusionais e o prognóstico dos pacientes criticamente enfermos que receberam CHA. MÉTODO: Estudo prospectivo de coorte realizado no CTI médico-cirúrgico de um Hospital Universitário durante 16 meses. Foram coletados dados demográficos, clínicos e os relacionados a transfusão de CHA.

Transfusão de concentrado de hemácias na unidade de terapia intensiva

“…(10,14,18) These rates are similar to other studies conducted in Brazil, 35%. (21,22) The transfusion rate for the patients in the HNSC study was 19,33%. Significant differences found in the transfusion rates may be explained by the patients population profile within a given hospital, as well as by the recommended treatments and possible complications.…”

“…(17,18) In the HNSC ICU there was a predominance of patients aged 60 years or older, and this feature is repeated in Brazilian ICUs. (21,22) This predominance of older patients coincides with a lager number of comorbidities and hospital stay. (6,17) In the study by Hebert et al, it was seen a prevalence of the male gender, 64%, similar to the observed in the Eastern Europe study.…”

“…This is repeated in other Brazilian trials, both the multicenter and the one by the HUCFF, where the mean ICU stay was 6 days. (21,22) Hebert et al found a 39% incidence of packed red blood cells transfused patients coming from the surgery center, and 16% from the emergency. (10) In the Eastern Europe 57.5% of the patients admitted due to emergency surgery were transfused.…”

“…In the Brazilian studies, more than 50% of the transfusion indications are related to the hemoglobin level, with no relationship to active bleeding. (21,22) The number of red blood cells transfused units ranged between 2.6-4.1 units/patient in an ICU multicenter study. (10) In Scotland it was found that the ICU surviving patients used an average 2.3 units per TE of this blood component.…”

“…(6,17) In two different studies in Scotland, the mean pre-transfusion Hb was 7.8 g/dL when not associated to hemorrhage, which was similar to the one in Brazilian ICUs. (14,18,21,22) Most of the TE in HNSC ICU had as criterion pretransfusion Hb values equal or above 7 and below 10 g/dL, averaging 8.11 g/dL (standard deviation ± 1.39).…”